12 posts shown.
swiftbear86 said:Who are you actually talking about here—the doctor or the manufacturer?
Would your take change if you found out the doctor was actually prescribing the very same drugs from that factory you're calling "generic"??
swiftbear86 said:I already told you what you need to do.😉
Look, a pharmacy is a business. They exist to make a profit, just like everyone else out there trying to make a buck.
They have to bring in enough money to cover payroll... 😛
swiftbear86 said:There’s actually a specific set of federal regulations regarding how prescriptions are written and filled.
http://www.medicare.gov/regulations/pharmacy_guidelines_example.pdf
Article 15 provides a breakdown of how this works.
Article 15.a
(1) Unless the doctor specifies otherwise on the prescription, the pharmacy can issue a single
original package of the lowest strength medication available.
(2) If a pharmacy doesn't have the exact medication prescribed, they are required to get it in
for the patient within 3 days at the latest, or ensure the patient can pick it up at another pharmacy.
(3) For refillable prescriptions, the medication is usually dispensed at the same pharmacy, unless it’s an
e-prescription, in which case the patient can go to any participating pharmacy.
(4) As an exception to Article 15, sections 1 and 2, if a pharmacy—during
the first fill or a refill of a recurring prescription—doesn't have the specific
brand in stock due to a shortage in the United States, the pharmacist has the right, without needing to
check with the prescribing doctor first, to provide the patient with a generic version of the same type at an equal or lower price from the approved list,
provided the doctor didn't explicitly write "no substitutions" on the script, and provided that
the patient agrees to the switch.
(5) When such a substitution happens under section 4, the pharmacist is required to note it on the prescription during
the initial fill, or update the electronic record for refills of
recurring prescriptions.
(6) If the patient refuses the generic alternative, the pharmacist will, during the initial fill,
return the prescription and send the patient back to their doctor to get a different one; for an e-prescription,
they'll direct the patient back to the doctor who issued the electronic order. If a patient
refuses the substitute during a refill request for a
recurring prescription, the pharmacist will close out the electronic record and refer the patient back to the
prescribing physician to adjust the prescription accordingly.
(7) If the doctor marks it for "refill..."
Pharmacies have to balance their business operations with keeping customers happy.
Look, it's just not realistic or necessary for a pharmacy to keep every single medication on the list in stock.
They stock what they know they can reliably dispense quickly without having inventory sitting on the shelves for months.
Usually, that means the common stuff doctors prescribe most often, which is easy to have on hand.
Considering how long it takes Medicare to reimburse pharmacies for what they dispense (sometimes up to 300 days!!!!), it’s honestly a miracle pharmacies even stay in business.
Doctors also need to keep an eye on the cost when they're writing these scripts.
Sumamed is definitely one of the pricier macrolides, yet doctors often just write down a generic like Azithromycin (which could be Sandoz or Belupo...) without ever mentioning the price difference to the patient.
When the patient walks into the pharmacy, they feel blindsided, like we're trying to pull a fast one on them.
Luckily, with e-prescriptions, we can show the patient a simplified version.
If they aren't happy with it, we usually just send them back to the doctor so they can work it out.
Patients often end up venting their frustration at the pharmacist while staying perfectly quiet with the doctor.
Then, once they get home and call the doctor, and the doctor says, "Well, that was Sumamed," suddenly everything is fine and they're happy again.
But honestly, it seems to me that the situation mentioned above isn't really about anything shady; it's just standard pharmacy procedure.
Basically, the script says Sumamed, they don't have it, so they offer a generic (per the rules) or tell the patient they'll order it for tomorrow.
That is completely standard practice.
I realize that doesn't make it any less frustrating for the patient, though.
If you suspect anything shady going on with how a pharmacy is running its business, you can file a report with the local Chamber of Commerce, Medicare, or the Department of Health and Human Services...
As for Concor, they’re still manufacturing it, but honestly, shortages happen all the time—and it’s not just with that one drug.
Someone mentioned an alternative AP up above without actually naming which one. Those tend to run out quite often too.
Veli visited the exact same pharmacy three times, so she's moving on now..
It happens to us more often than you'd think: a patient comes in, we don't have what they need, we order it for tomorrow, and then they just never show up. We end up putting the medication back on the shelf because why bother letting it sit there and take up space? Then, three months later, the same person walks in and claims we *never* have it in stock. If they had just come by the next day like they said they would, we'd know they were a regular, and we would've made sure to have it ready for them next month.
swiftbear86 said:So, what's the big deal, anyway?
Look, if the doctor insists that it absolutely has to be Sumamed, then fine—let them go ahead and order it themselves.
It’s honestly such a bummer when my sister has to switch up her medication, and then the pharmacist isn't even allowed to offer her the exact same thing. It just feels like an unnecessary hurdle.
Nah, I don't think that's quite what you meant...😉
So, I was thinking about this the other day. When we run out of a specific medication and have to call the doctor—you know, calling the actual physician rather than just checking in with a nurse—do they usually just tell us to use whatever we have left in the cabinet, or are they strict about needing that exact brand or dosage written down? Sometimes, if there’s another pharmacy just a few blocks away, the doctor might even suggest taking a little stroll to go find the specific one they prescribed instead of just settling.
We might actually see that medication hit the shelves by tomorrow afternoon, but honestly, that’s a total fluke. Usually, you're looking at much longer waits. We always seem to have Sumamed on hand around here.🙂
swiftbear86 said:It’s definitely possible that there's an odor involved, too.😁
But look, if your doctor actually writes it right there on the prescription... Look, if they tell you that you aren't allowed to switch up a prescribed medication, then you're stuck. It’s not even a choice at that point—the software simply won't let me make the change. .
Look, I get it. If you’re living out in a tiny rural town or some small village where there's only one pharmacy for miles, you basically have to take whatever they've got on the shelf. I'm definitely not saying that's okay or making excuses for it, but I can certainly understand why someone would feel stuck. When you don't have options, you don't really have a choice.☕
melloworca6 said:Are we talking about all these drugs coming from the same handful of big corporations? Like, the doctor writes a prescription for something from Bayer, but she ends up pushing something from Pfizer instead.
melloworca6 said:Look, it doesn't matter what side you're on, you can't deny things look shady when this kind of stuff keeps happening. If a doctor writes a specific prescription and they just insist on pushing some substitute—and then turn around and attack anyone who dares to push back—something smells fishy to me. 🤷
Tyler James5 said:So I just realized you were actually trying to track down some Sumamed and came up empty—was I wrong about that? Or was that just something the pharmacist mentioned since you actually managed to snag it?
And yeah, look, not everyone needs it. That was kind of my whole point in the last post...
Tyler James5 said:A few months back, the FDA issued a warning about how Azithromycin might mess with your heart's electrical activity, which could lead to fatal arrhythmias. The risk is higher for patients with existing heart conditions, low potassium or magnesium levels, slow heart rates, or those on certain other medications. (Also, there was a study in the NEJM last year showing a statistically significant increase in cardiovascular deaths among Azithromycin users compared to those taking different antibiotics or nothing at all.)
So, maybe don't go yelling at your doctor over this.
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Tyler James5 said:So, at the local pharmacy—well, let's call it what it really is, a convenience store... they don't want to (read: they can't afford to) keep a massive stock on hand because the foot traffic just isn't there. Instead, they grab maybe one or two items from each category, and they’re almost certainly grabbing the cheap generic versions. It's the exact same chemical makeup and does the exact same thing, it just doesn't have that fancy original brand name on the box.
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